Preventative medication will protect people at risk of HIV

Effective Jan. 1, 2018, British Columbians at high risk of HIV infection will be able to receive pre-exposure prophylaxis (PrEP), a daily oral antiretroviral medication that prevents new HIV infection, at no cost.

Daily use of PrEP is recommended by the World Health Organization and the BC Centre for Excellence in HIV/AIDS as an effective method to prevent HIV in people at risk of infection. It is part of a suite of tools to prevent new HIV infections, including use of condoms and sterile drug use equipment, and other risk-reduction services and supports.

People at risk include men and transwomen who have sex with men, people who inject drugs, and people who have sex with individuals living with HIV.

In August 2016, the Common Drug Review recommended PrEP for coverage, contingent in part on a lower price for the drug Truvada being secured. This condition has been met through the availability of generic Truvada.

While HIV/AIDS-related deaths in B.C. have decreased by more than 90 per cent since 1996, new cases of HIV continue to emerge. In 2015, there were 5.1 new diagnoses of HIV per every 100,000 people in British Columbia. Increased access to PrEP will help prevent new HIV infections.

PrEP will be available through the BC Centre for Excellence’s HIV Drug Treatment program, which is funded by the Ministry of Health through the B.C. PharmaCare program. People interested in accessing it should talk to their health-care provider.

Since its establishment in 1992, the BC Centre for Excellence in HIV/AIDS has worked to improve the health and longevity of people living with HIV, and to prevent new HIV infections through research, innovation and treatment programs.

In addition, the Province is expanding the existing PEP program to include coverage for non-occupational exposure. This publicly funded program ensures that British Columbians who are not taking PrEP, but who are exposed to HIV, have immediate access to PEP in order to prevent a new infection.

PrEP is one component of the made-in-B.C. strategy known as Treatment as Prevention, a strategy pioneered by the BC Centre for Excellence in 2005 to expand the reach of HIV treatment in order to reduce morbidity, mortality and HIV transmission. This expansion forms the basis of the provincial Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) program, with $19.9 million in annual funding coming from the Ministry of Health.

Treatment as Prevention has been adopted worldwide, and has provided the basis for the United Nations endorsed strategy aimed to “End AIDS as a Public Health Threat by 2030.”

Newly diagnosed HIV infections are down by two-thirds since the introduction of highly active antiretroviral therapy. However, the number of newly diagnosed infections in some communities (including men who have sex with men) continues to be high.

PEP has been available since 1998 for people who encounter an isolated HIV exposure, predominately in the occupational setting, and more recently through a limited pilot program following accidental non-occupational exposure.